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U.S News Best Hospitals 2021-22: New Ratings in Seven Procedures, Conditions to Debut in July

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On July 27, when U.S. News publishes the 2021-22 edition of Best Hospitals, seven new ratings will be included, expanding the Procedures & Conditions portfolio to 17 services in all. The new ratings will cover Heart Attack, Stroke, Pneumonia, Diabetes, Kidney Failure, Hip Fracture and Back Surgery (Spinal Fusion). More than 4,000 hospitals will receive a rating in one or more of the newly rated services.

The methodology for each of the new ratings will follow the general approach that has been used in existing Procedures & Conditions ratings. For example, each new rating will be a composite of multiple quality indicators, including risk-adjusted mortality; physicians’ opinions will not be a factor in any of the new ratings.

In addition to the seven new ratings, this year’s edition of Best Hospitals will feature several other notable changes:

  • Equity. Measurement and public reporting of health disparities may help hospitals make targeted interventions that advance health equity among the patients and within the communities they serve. Therefore, U.S. News has developed measures of certain aspects of health equity that will be published alongside the rankings and ratings on July 27. These novel measures will not be factored into this year’s rankings and ratings. A larger portfolio of health equity measures is under development.
  • Nephrology. There will no longer be a ranking in adult Nephrology. The new Kidney Failure rating, which covers nearly all of the same hospital admissions, will replace that specialty ranking.
  • Rehabilitation. This year’s Rehabilitation ranking will employ a new methodology that has been in development since 2019. Nearly 1,000 hospitals were included in the analysis.
  • Transparency. A measure of public transparency will be incorporated into three of this year’s ratings – Heart Attack, Heart Failure and Stroke – based on each hospital’s public reporting status in relevant clinical registries. To receive credit for the transparency measure in the Heart Attack and Heart Failure ratings, a hospital had to have voluntarily opted to publicly report via at least one of the American College of Cardiology’s registries or at least one of the American Heart Association’s cardiology-related registries; the same criteria were used this year to determine which hospitals receive credit for transparency in the Cardiology & Heart Surgery rankings. To receive credit for transparency in the Stroke rating, a hospital had to have voluntarily opted to publicly report via the American Heart Association’s stroke registry, following the same criteria U.S. News introduced last year to determine transparency credit in the Neurology & Neurosurgery rankings.
  • Discharge to home. In calculating risk-adjusted rates of discharge to home, several exclusions were incorporated. For example, patients admitted from nursing facilities and patients discharged to home hospice are no longer included in this measure.
  • Nurse staffing. In calculating each hospital’s level of nurse staffing, U.S News used three years of data reported to the American Hospital Association. This smooths large year-to-year fluctuations in nurse staffing reported at some hospitals, often smaller hospitals.
  • Best Regional Hospitals. To be recognized as a Best Regional Hospital this year, a hospital had to (a) provide general medical and surgical services, (b) receive at least 6 high performing ratings across the 17 Procedures & Conditions or a national ranking in at least one of 11 data-driven adult specialties, and (c) receive at least three more high performing ratings than below average ratings across the Procedures & Conditions. In determining the Best Regional Hospitals, each hospital’s performance in Aortic Valve Surgery and TAVR were combined into a single rating, since these two procedures are used to treat the same medical condition. Neither Rehabilitation nor Nephrology factored in Best Regional Hospitals this year. Nationwide, 531 hospitals were identified as Best Regional Hospitals, compared to 563 last year.
  • Overuse. Overtreatment and low-value care may cost more than $100 billion per year. In the new Back Surgery (Spinal Fusion) rating, a measure of overuse that was calculated for U.S. News by data scientists at the Lown Institute, was utilised. This measure is also a component of the Overuse metric of the Lown Institute Hospitals Index. Because a pattern of overuse or low-value care is not compatible with being a high-quality provider, U.S. News will explore additional opportunities to incorporate measures of value in future editions of Best Hospitals.

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